Valery Vishnevskiy¹, Christian Guenthner¹, Charles McGrath¹, and Sebastian Kozerke^1
1University and ETH Zurich, Zurich, Switzerland

We investigated the feasibility of accelerating cardiac cine imaging on a 0.75T lower-field MRI system by performing retrospective k-t undersampling of cine data at acceleration factors of 3 to 10. Reconstructed images show no unexpected artefacts with nRMSE of 0.6% at 7-fold acceleration. Additionally, the magnetohydrodynamic effect (MHD) in the electrocardiogram was significantly reduced at 0.75T compared to 1.5T promising rapid and robust cine imaging at lower field.

David Lohr¹, Maya Bille¹, Maxim Terekhov¹, Michael Hock¹, Ibrahim Elabyad¹, Steffen Baltes¹, Alena Kollmann¹, Theresa Reiter^1,2, Florian Schnitter², Wolfgang Rudolf Bauer^1,2, Ulrich Hofmann², and Laura Maria Schreiber^1
1Chair of Molecular and Cellular Imaging, Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany, ²Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

Ultrahigh field cardiac MRI in a large animal model with acute and chronic infarction is feasible and enables high resolution functional imaging with 4- to 16-fold higher in-plane resolution compared to clinical systems. Blood-tissue contrast enabled clear identification of tissue boundaries, papillary muscle and the valves. Apical slices were akinetic. Mean values for ejection fraction [%] at baseline and 3-4, 10-14, and 60 days post MI were: 66±5, 45±7, 49±10, 50±5, respectively. Coefficients of variation for intra- and inter-observer variability in ejection fraction were 1.5% and 6.2%. T₂*-weighted images and LGE enabled visualization of the infarct area.  

Lu Huang¹, Qi Liu², Jingyuan Lyu², Zhongqi Zhang³, Yanqun Teng³, Shuheng Zhang³, Jian Xu², Weiguo Zhang², and Liming Xia^1
1Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²UIH America, Inc., Houston, TX, United States, ³United Imaging Healthcare, Shanghai, China

Here we report our initial clinical experience using a prototype 2D cardiac MR T1 cine multitasking technique with inline reconstruction on a clinical scanner without breath-hold and ECG triggering. Its results were compared with routine clinical cardiac MR techniques in assessing lesions in a patient group.

Ezgi Berberoglu¹, Christian Stoeck¹, Sebastian Kozerke¹, and Martin Genet^2
1Institute for Biomedical Engineering, University and ETH Zurich, Zürich, Switzerland, ²Solid Mechanics Laboratory, École Polytechnique, Palaiseau, France

Prognostic value of deformation metrics extracted from cine MR images has been shown by numerous studies in the clinical setting, but with some limitations to detect local changes in the myocardium. Tagged CMR, however, allows tracking material points on the heart wall, revealing local myocardial deformation. Although it is superior to cine MRI in quantification of myocardial torsion, radial strain is often omitted. In this contribution, we enrich our registration technique with the capability to combine cine and tagged in-vivo CMR images, improving accuracy of regional strain assessment from tagged images while acquiring global deformation from cine CMR images.

Jian He¹, Gang Yin¹, Weichun Wu², and Minjie Lu^1
1Department of Magnetic Resonance Imaging, Fuwai Hospital & Cardiovascular Institute, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, National Center for Cardiovascular Diseases, beijing, China, ²Department of Ultrasound, Fuwai Hospital & Cardiovascular Institute, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, National Center for Cardiovascular Diseases, beijing, China

In this retrospective study, 167 HFpEF patients (median age 60 years, 40% women) were included. At a median follow-up of 110 (IQR 104–120) months, 71 patients experienced the primary composite outcome of all-cause death and HF hospitalization. Impaired global early diastolic longitudinal strain rate (eGLSR), defined as an eGLSR < median, 0.57/s, was present in 49.7% of patients and was predictive of the composite outcome (adjusted HR 2.57, 95% CI 1.58–4.45; p=0.001), and HF hospitalization alone (adjusted HR 2.48, 95% CI 1.31–4.70; p=0.005) after adjusting for clinical and conventional imaging variables.

Nazia Husain¹, Michael Markl², Kae Watanabe³, Cynthia Rigsby³, and Joshua D Robinson^3
1Pediatric Cardiology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States, ²Northwestern University, Chicago, IL, United States, ³Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States

Current gold standard for surveillance of pediatric heart transplant (PHT) complications is invasive and imperfect. CMR allows non-invasive evaluation of myocardial structure and function.  A retrospective review of 26 PHT who underwent regadenoson stress perfusion CMR with tissue characterization and 18 age-matched controls was performed. Global T1 and ECV were higher in PHT; as were biventricular volumes and cardiac output. Myocardial perfusion reserve index was lower in PHT. Structure-function correlations between LVEF and strain versus T2 were noted.  T1, ECV were associated with clinical rejection scores. CMR comprehensively evaluates myocardial alterations in PHT.

Jiamin Zhang¹, Mengchun Jiang¹, Mu Zeng¹, and Xiaoyue Zhou^2
1Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China, ²MR Collaboration, Siemens Healthineers Ltd, Shanghai, China

We used tissue tracking cardiac magnetic resonance (TT-CMR) to quantitatively analyze the global, regional, and layer-specific strain of isolated left ventricular noncompaction (ILVNC). Combined with late gadolinium enhancement (LGE), we initially explored the effect of focal myocardial fibrosis on myocardial strain

Shenglei Shu¹, Jing Wang¹, and Xiaoyue Zhou^2
1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²MR Collaboration, Siemens Healthineers Ltd., Shanghai, China

The prognostic value of strain parameters from cardiac magnetic resonance (CMR) cine images has been rarely studied in patients with severe dilated cardiomyopathy (DCM). In this study, we retrospectively identified 129 patients with severe DCM who underwent CMR. Strain and conventional CMR parameters were acquired from baseline CMR. The prognostic value of CMR parameters and clinical data for predicting adverse events was analyzed using Cox regression analyses. Global circumferential strain (GCS) was independently associated with adverse events after adjusting for clinical and imaging risk factors. GCS from CMR feature-tracking could be useful for risk stratification in patients with severe DCM.   

Chi Wai Michael Liu¹, Gladys LO GOH¹, Cindy Xue², Raymond Lee¹, Wai Kit Chung¹, Ka Man Cura Chan¹, Kwai Sin Frederick Kong¹, Po Lung Polo Chan¹, Wing Wa Li¹, Chun Ta Yuen¹, and Johnny Tang^1
1Department of Diagnostic and Interventional Radiology, HKSH Eastern Medical Centre, Hong Kong, Hong Kong, ²HKSH Eastern Medical Centre, Hong Kong, Hong Kong

The reliability of the left-ventricular ejection function estimated from the compress-sensing accelerated cardiac MR scan was evaluated in the study. Excellent inter-observer and intra-observer agreement were observed based on the data from the compress-sensing cardiac MR scans, suggesting the usefulness of compress-sensing acceleration in improving the patient comfort and scan time reduction without degrading the reliability in the cardiac output assessment.

Yang-yang Qu^1,2, Dominik Buckert¹, and Volker Rasche^1
1Internal Medicine II, Ulm University, Ulm, Germany, ²Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China

To better understand the mechanics of left and right atrium, radial and longitudinal strains of atrial free wall was quantified using cardiovascular magnetic resonance based tissue tracking (CMR-TT) technique. Gender- and age-specific reference values were generated among a healthy population (n=150). Larger magnitudes of strains were noticed in females and the younger. CMR-TT has been proven as a feasible and reproducible technique in this study, and the gender- and age-specific references need to be established for the clinical practice.

Ulrich Katscher¹ and Steffen Weiss^1
1Philips Research Europe, Hamburg, Germany

In addition to electro-physiological examinations, mapping the passive bulk conductivity would complete a comprehensive characterization of myocardial tissue. The technique to measure this conductivity with MRI, called “Electrical Properties Tomography” (EPT), has been developed some time ago, but not yet explored for the human heart. This study investigated and confirmed two basal goals of cardiac EPT: (a) that cardiac EPT is technically feasible, (b) that quantitative conductivity values of myocardium and blood, obtained from a small group of volunteers, are in line with expectations from literature.

Di Tian¹, Shuangchun Ma¹, Ziqi Xiong¹, Xin Li¹, Qingwei Song¹, Ailian Liu¹, and Zhiyong Li^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, Dalian, China

The purpose of this study is to explore the correlation between smokers' left atrium (LA) myocardial strain (MS), total ejection fraction (EFtotal) parameters and smoking parameters. This study demonstrated that LA global longitudinal strain (GLS) was significantly impaired and reduced with prolonged duration of smoking, smoking intensity and smoking burden.

Delphine Perie-Curnier¹, Egidie Uwase¹, Maxime Caru¹, Maxence Abasq¹, and Daniel Curnier^2
1Mechanical Engineering, Polytechnique Montreal, Montreal, QC, Canada, ²Kinesiology, Université de Montréal, Montreal, QC, Canada

Despite the late development of cardiac dysfunction in childhood acute lymphoblastic leukemia survivors, early detection of doxorubicin-related cardiotoxicity remains a challenge to better stratify these survivors who need a close follow-up. Cine-CMR acquisitions, combined to cardiopulmonary exercise testing and CircAdapt simulations showed that survivors’ exposition to doxorubicin, whatever the cumulative dose received, affected the cardiac efficiency and the ventricular-arterial coupling at rest and for light cardiac stress. Moreover, dexrazoxane treatments helped survivors to better adapt to high cardiac stress while presenting no differences at rest and for light cardiac stress.

Xuan Li¹, Jiang Wu¹, Chaohui Yang¹, Lina Zhu¹, Heng Niu¹, Xiaoyong Hao¹, and Kaiyu Wang^2
1Shanxi Cardiovascular Hospital, Taiyuan, China, ²GE Healthcare, MR Research, Beijing, China

CMR-FT can quantitatively evaluate myocardial motion. In this study, we find that the right ventricular global longitudinal, radial and circumferential strain in ARVC patients are significantly lower than those in normal controls. In ARVC patients with LVEF < 55%, the left ventricular global longitudinal, radial and circumferential strain decrease significantly. The left ventricular global longitudinal strain also decrease in ARVC patients with LVEF ≥ 55%. These results suggested that myocardial strain can be used to evaluate biventricular myocardial motion in ARVC patients.

Jingwen Dai¹, Min Zhang¹, Jing An², and Min Chen^1
1Beijing Hospital, National Center of Gerontology, Beijing, China, ²Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China

To investigate the differences in basal septal hypertrophy in elderly people between ventricular septal bulge(VSB) and hypertrophic cardiomyopathy(HCM) based on myocardial strain analysis, A total of 13 VSB subjects, 9 HCM patients, and 8 healthy controls underwent cardiac MR scan. The strain parameters shows significant differences between VSB and HCM, and no significant differences between VSB and healthy controls. These findings may suggest a different underlying pathological change and provide a potential diagnostic clue in distinguishing VSB and HCM in elderly people.

Lina Zhu¹, Jiang Wu¹, Xiaoyong Hao¹, Xuan Li¹, Zhaohui Yang¹, Heng Niu¹, and Kaiyu Wang^2
1Shanxi Cardiovascular Hospital, Taiyuan, China, ²GE Healthcare, MR Research, Beijing, China

    In this study, myocardial strain parameters was used to distinguish Isolated left ventricular noncompaction (ILVNC) and dilated cardiomyopathy (DCM). The results showed that the apex longitudinal strain (LS) had great potential in the differential diagnosis of ILVNC and DCM, and different change patterns are presented in the LS of the myocardium from the basal segment to the apex.

yang chen¹, Wen Qian¹, Xiao yue Zhou², Yi Xu¹, and Xiao mei Zhu^1
1the First Affiliated Hospital of Nanjing Medical University, Nanjing, China, ²Siemens Healthineers Ltd, Shanghai, China

Although segmented cine cardiac magnetic resonance (CMR) is the standard choice for assessing left ventricular (LV) volume, single-shot compressed sensing (CS) cine CMR can provide similar information with shorter examination times. A total of 37 healthy patients underwent both single-shot CS and standard segmented cine imaging. The single-shot CS global strain and standard deviation of the time to peak strain were poorly to moderately correlated with those of the standard segmented cine. Inter- and intraobserver variability for LV strain were mostly good to excellent for both groups.

Shuang Leng¹, Ru-San Tan^1,2, Ping Chai^3,4, Wen Ruan¹, Ting Ting Low^3,4, Lynette Teo^4,5, Tee Joo Yeo^3,4, Xiaodan Zhao¹, John C. Allen², Jonathan Yap¹, Soo Teik Lim^1,2, James W. Yip^3,4, Ju Le Tan^1,2, and Liang Zhong^1,2
1National Heart Centre Singapore, Singapore, Singapore, ²Duke-NUS Medical School, Singapore, Singapore, ³National University Heart Centre, Singapore, Singapore, ⁴Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, ⁵National University Hospital, Singapore, Singapore

Pulmonary artery (PA) stiffness in pulmonary arterial hypertension (PAH) is strongly associated with clinical progression of the disease. This study aimed to introduce a novel parameter—PA global longitudinal strain (GLS)—for PA stiffness assessment using a semi-automated feature-tracking approach with standard cine cardiovascular magnetic resonance (CMR). Reduced PA GLS was significantly associated with increased pulmonary artery pressure and pulmonary vascular resistance in PAH. In addition, PA GLS was significantly impaired in PAH patients with hemodynamically decompensated right ventricular (RV) function compared to those with compensated RV function. 

Jadranka Stojanovska¹ and El-Sayed H Ibrahim^2
1University of Michigan, Ann Arbor, MI, United States, ²Medical College of Wisconsin, Milwaukee, WI, United States

Left ventricular (LV) dysfunction as identified by depressed systolic function is an independent predictors of mortality and hospitalization with ischemic cardiomyopathy. LV systolic function as defined by the ejection fraction (EF) is quantified using cardiac imaging. We hypothesize that subset of patients with ischemic cardiomyopathy and normal LV EF of 55% demonstrate impairment in cardiac contractility by strain imaging. The results showed that the nonlinear relationship between LVEF and myocardium global circumferential-strain is indicative that EF is not sensitive to regional cardiac dysfunction or LV remodeling. Cardiac strain should become the cornerstone of the evaluation of patients with ischemic cardiomyopathy.

Emine Can¹, Megan Smith¹, Rochelle Buffenstein¹, and Johannes Riegler^1
1Calico Life Sciences LLC, South San Francisco, CA, United States

Naked mole-rats are extremely long-lived (>38 years) small (35-60g) rodents that show no increased risk of dying as they get older, implying that organ function is well-maintained throughout life. Using cardiac MRI, ultrasound and large cohorts of both mice and mole-rats we undertook a comprehensive comparative analysis of age-related changes in cardiovascular function over their lifespans. Unlike mice that show declines in most measurements of cardiac function and increased left ventricle wall thickness with age, we found naked mole-rats maintain cardiac function and functional cardiac reserve capacity well into their fourth decade of life.